scholarly journals Stereotactic Hypofractionated Irradiation for Metastatic, Inoperable, and Recurrent Malignancies: A Modern Necessity, rather than a Luxury

2014 ◽  
Vol 2014 ◽  
pp. 1-13
Author(s):  
Sridhar P. Susheela ◽  
Swaroop Revannasiddaiah ◽  
Ajaikumar Basavalingaiah
Keyword(s):  
Local Control ◽  
Disease Recurrence ◽  
Stereotactic Irradiation ◽  
Conventional Radiotherapy ◽  
Conventional Fractionation ◽  
High Fraction ◽  
Clinical Adoption ◽  
Hypofractionated Irradiation

Stereotactic-irradiation combines highly conformal delivery of radiation to selected volumes at large doses per fraction, with the treatment completed typically within one to five fractions. The radiobiological equivalence of doses delivered by stereotactic-irradiation (often beyond 80–100 Gy) is much higher in comparison to the doses achievable by conventional fractionation. At the high fraction sizes used in stereotactic-irradiation, evidence suggests the role of various radiobiological mechanisms of actions, which are not traditionally relatable with conventional radiotherapy. In spite of the accumulating evidence in favour of the efficacy of stereotactic irradiation in terms of improving local control and at times attaining increments in survival, the clinical adoption of the technique remains dismal. This review provides a brief description of the available evidence describing the benefits of stereotactic-irradiation for the management of patients with oligometastases, unresectable malignancies and for disease recurrence after prior radiotherapy. Given the growing body of evidence illustrating the efficacy of stereotactic irradiation among patients with conditions which were previously often regarded as untreatable, it is likely that the widespread adoption of stereotactic irradiation may achieve cure in a few patients, while in the remainder providing prospects of long term local control. This could be a step in the direction of converting incurable malignancies into chronic controllable diseases.

Extramedullary Nasal Plasmacytoma — An Unusual Clinical Entity

1996 ◽  
Vol 75 (3) ◽  
pp. 171-173 ◽  
Author(s):  
Gordon Soo ◽  
Anthony Chan ◽  
Dennis Lam ◽  
Victor Abdullah ◽  
C. Andrew van Hasselt
Keyword(s):  
World Literature ◽  
Residual Disease ◽  
Disease Recurrence ◽  
Extramedullary Plasmacytoma ◽  
Intracranial Extension ◽  
Long Term Follow Up ◽  
Unusual Appearance

A case of extramedullary plasmacytoma with its unusual appearance is reported. This is the second reported case in world literature affecting the paranasal sinuses with intracranial extension. The role of surgery is to obtain tissue for diagnosis and to excise residual disease. Radiotherapy is the treatment of choice and long-term follow-up is necessary for monitoring disease recurrence. The overall 10-year survival is about 50%. The case is discussed with a general review of the management of this pathology.

scholarly journals Durable 5-year local control for resected brain metastases with early adjuvant SRS: the effect of timing on intended-field control

2021 ◽  
Author(s):  
Evan D Bander ◽  
Melissa Yuan ◽  
Anne S Reiner ◽  
Katherine S Panageas ◽  
Åse M Ballangrud ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Recurrence Rate ◽  
Local Control ◽  
Recursive Partitioning ◽  
Disease Recurrence ◽  
Incidence Rates ◽  
Urgent Care ◽  
Kaplan Meier ◽  
Surgical Recurrence

Abstract Background Adjuvant stereotactic radiosurgery (SRS) improves the local control of resected brain metastases (BrM). However, the dependency of long-term outcomes on SRS timing relative to surgery remains unclear. Methods Retrospective analysis of patients treated with metastasectomy-plus-adjuvant-SRS at Memorial Sloan Kettering (MSK) between 2013-2016 was conducted. Kaplan-Meier methodology was used to describe overall survival (OS) and cumulative incidence rates were estimated by type of recurrence, accounting for death as a competing event. Recursive partitioning analysis (RPA) and competing-risks regression modeling assessed prognostic variables and associated events of interest. Results Two hundred eighty-two patients with BrM had a median OS of 1.5 years (95% CI: 1.2-2.1) from adjuvant SRS with median follow-up of 49.8 months for survivors. Local surgical recurrence, other simultaneously SRS-irradiated-site recurrence, and distant central nervous system (CNS) progression rates were 14.3% (95%CI: 10.1-18.5), 4.9% (95%CI: 2.3-7.5), and 47.5% (95%CI: 41.4-53.6) at 5 years, respectively. Median time-to-adjuvant-SRS (TT-SRS) was 34 days (IQR: 27-39). TT-SRS significantly associated with surgical site recurrence rate (p=0.0008). SRS delivered within 1 month resulted in surgical site recurrence rate of 6.1% (95%CI: 1.3-10.9) at 1-year, compared to 9.2% (95%CI: 4.9-13.6) if delivered between 1-2 months, or 27.3% (95%CI: 0.0-55.5) if delivered >2 months after surgery. OS was significantly lower for patients with TT-SRS >~2 months. Post-operative length of stay, discharge to a rehabilitation facility, urgent care visits and/or disease recurrence between surgery and adjuvant SRS associated with increased TT-SRS. Conclusions Adjuvant SRS provides durable local control. However, delays in initiation of post-operative SRS can decrease its efficacy.

Role of Dermatologists in Treating Melanoma

2006 ◽  
Vol 4 (7) ◽  
pp. 695-702 ◽  
Author(s):  
Allan C. Halpern ◽  
Sanjay K. Mandal
Keyword(s):  
Primary Melanoma ◽  
Disease Recurrence ◽  
Lymph Node Biopsy ◽  
Warning Signs ◽  
Melanoma Detection ◽  
Early Warning Signs ◽  
Excision Margins

Melanoma is a major focus of dermatology training and practice, with dermatologists playing a central role in managing melanoma through primary prevention, secondary prevention, diagnosis, and treatment of thinner tumors. Dermatologists have led public health efforts to raise melanoma awareness, promulgate the early warning signs of melanoma, and promote melanoma prevention through sun protection. Dermatologists have unique expertise in melanoma risk assessment and the clinical diagnosis of melanoma through visual inspection and the use of diagnostic aids, including dermoscopy and photographically assisted follow-up. Increasing incidence of melanoma, earlier melanoma detection, narrower excision margins, and improved surgical training in dermatology have recently combined to enhance the role of dermatologists in melanoma care. For patients with thin primary melanomas, dermatologists are increasingly assuming complete care, including wide local excision and long-term surveillance for both disease recurrence and detection of new primary melanoma. Conversely, the advent of sentinel lymph node biopsy and adjuvant therapy has made melanoma management more complex and has intensified the need for a multidisciplinary approach to the disease. In this context, dermatologists contribute significantly to the formation, administration, and implementation of multidisciplinary melanoma programs.

Multimodal Management of Metastatic Malignant Meningiomas: The Role of Radiosurgery in Long-Term Local Control

2019 ◽  
Vol 128 ◽  
pp. 562-572
Author(s):  
Luca Attuati ◽  
Ismail Zaed ◽  
Carlotta Morselli ◽  
Guido Pecchioli ◽  
Maurizio Fornari ◽  
...  
Keyword(s):  
Local Control ◽  
Multimodal Management

1461: Local Control and Long Term Disease Free Survival Following Radical Prostatectomy for D1 Prostate Cancer In The PSA ERA

2004 ◽  
Vol 171 (4S) ◽  
pp. 385-385 ◽  
Author(s):  
Carl K. Gjertson ◽  
Kevin P. Asher ◽  
Joshua D. Sclar ◽  
Aaron E. Katz ◽  
Erik T. Goluboff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Local Control ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up

The Second Start of Transformation in Ukraine?

2014 ◽  
pp. 30-52 ◽  
Author(s):  
L. Grigoryev ◽  
E. Buryak ◽  
A. Golyashev
Keyword(s):  
Economic Growth ◽  
Armed Conflict ◽  
Political Crisis ◽  
Investment Climate ◽  
Institutional Reforms ◽  
Personal Consumption ◽  
Governance Quality ◽  
Political Turmoil

The Ukrainian socio-economic crisis has been developing for years and resulted in the open socio-political turmoil and armed conflict. The Ukrainian population didn’t meet objectives of the post-Soviet transformation, and people were disillusioned for years, losing trust in the state and the Future. The role of workers’ remittances in the Ukrainian economy is underestimated, since the personal consumption and stability depend strongly on them. Social inequality, oligarchic control of key national assets contributed to instability as well as regional disparity, aggravated by identity differences. Economic growth is slow due to a long-term underinvestment, and prospects of improvement are dependent on some difficult institutional reforms, macro stability, open external markets and the elites’ consensus. Recovering after socio-economic and political crisis will need not merely time, but also governance quality improvement, institutions reform, the investment climate revival - that can be attributed as the second transformation in Ukraine.

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